Thursday, December 28, 2017

Emma has not worn her blanket for the past couple of winters. She grows a super thick coat and by the time the really cold weather sets in, she fluffs up like a dandelion and stays nice and warm. This year, this really cold weather is coming somewhat early and on the heels of a fairly mild fall. I held up her blanket and asked her if she wanted it. She usually just walks off as soon as I reach for it, but this time, she headed over and stuck her head through it so I had my answer. She is certainly not overly warm in it, which is a hazard of blankets. It is very bad if they sweat under the blanket - they will end up even colder and in danger of frostbite if that happens. No sweating going on around here though.

I lured everyone out of the barn for an hour or so this afternoon by letting them out on forbidden pasture grass. It gave them something to do for a bit and gave me some time and space to clean the barn. They were back long before I had finished though. The frozen, snow-covered grass was no match for the cold and wind.

They picked their favorite spots up against the slightly sun-warmed wall of the barn and napped while I worked.

Stopping to slide my frozen hands up under one of those warm blankets was handy though.

Although Ramsey gets annoyed with me if I try to use him as a hand warmer. I can't say as I blame him, I wouldn't want my icy fingers creeping up my backside either.

There is not much to do around here at the moment other than hunker down and stay out of the wind.

Monday, December 25, 2017

People ask me all the time what I get my donkeys for Christmas. Those who know me, know that I am not fond of Christmas for a variety of reasons and one of them is the way giving gifts has become obligatory. I like giving gifts and if you hang around long enough, you may find yourself the recipient of a random present here or there.

As for the donkeys and my other animals, I do all I can, day in and day out, to make everyday like Christmas - only better because, thankfully, not every day is miserably cold, snowy and windy like today.

Thursday, December 21, 2017

Sunday, December 17, 2017

Cushing's disease is a very serious condition, but it is treatable, much like diabetes in people. Before there was a viable treatment for it, Cushing's used to be a death sentence. Now, it is a serious, but manageable disease that requires careful monitoring and treatment. With proper care, most equines can live a full, happy and useful life regardless of Cushing's. That is certainly what we are aiming for.

There is only one truly viable treatment for Cushing's disease: it is a drug called pergolide. This was originally used in humans to treat Parkinson's disease, but it caused some heart and lung valve problems and was taken off the market. Since it was the only drug available to treat Equine Cushing's, taking it off the market was a huge problem for horse and donkey owners.

After pergolide was withdrawn, the FDA finally agreed to look the other way when compounding pharmacies made pergolide for horse owners. Eventually, a new drug made just for horses came on the market that contains pergolide, it is called Prascend.

Like all new drugs, the big problem with Prascend is that it is horribly expensive. At some point, after the patent expires, a generic version will come out, but until then all of us who own equines with Cushing's disease are stuck paying the devil his due.

Compounded pergolide is still available at a significantly lower price, but the consistency and quality are suspect. We may try it anyway since the Prascend is so expensive and the animal has to be on the drug for the rest of his life. We'll see.

Some people have had success using chaste tree berry to treat Cushing's, but this is generally only effective in the very early stages. Since Cushing's is a chronic, progressive disease, eventually most animals will need pergolide. I did have Ben on chaste tree powder before his diagnosis because it can be helpful for insulin resistance, it is cheap, easy and I had my suspicions about Cushing's. Unfortunately, his ACTH levels were still too high so clearly, the chaste tree was not enough.

The biggest hurdle to treating Cushing's is the expense. The medication is terribly expensive as is the need for routine blood tests to monitor the progress and treatment efficacy. It becomes a real burden because the treatment and testing are required for the rest of the animal's life. There are many owners who simply cannot or will not make such an investment and many cushinoid horses end up at the meat market.

Hawkeye has been on Prascend for about 6-8 weeks now. He had his ACTH levels retested last week and we just got the good news that, after 6 weeks of treatment, his levels are down to normal. After a period of adjustment to the medication, he is feeling much better. This means that he will stay on his current dose of pergolide for the foreseeable future. He will get another blood test next year to see if his dose needs adjustment. Once his levels have been stable for a while, he will likely get retested twice a year to keep them that way.

I will be very interested to see how Hawkeye's feet shape up now that he is being treated. I expect some big changes.

Like all drugs, Prascend is not without its tribulations. Side effects are fairly common during the first couple weeks and the dose needs to be tapered upwards gradually to alleviate this. The most common side effects are lethargy, depression and loss of appetite. A slightly less common issue is diarrhea. In a few animals, pergolide causes anxiety, aggression, restlessness, irritability and not wanting to be touched.

This last is what happened with Ben when I tapered his dose up to 0.5mg.

Donkeys are (of course!) harder to treat. They are more prone to have adverse side effects than horses and their dose needs to be tapered upward even more slowly than in horses. This can be very difficult in small donkeys because it is hard to get the dose low enough. Equines are very sensitive to pergolide and absurdly low doses have a big impact. Treating mini donkeys can be a real challenge because of these dosing issues.

I started Ben, who weighs approx. 850lbs, on 0.25 mg dose (which is far less than a human would get) and he did fine for the first week so I increased the dose to our target of 0.5 mg. This is when I noticed some definite behavior changes.

Ben is generally very laid back, quiet and cuddly. For about a week, he was impatient, irritable, pawing at the gate, uninterested in ear rubs, annoyed with everything and he even chased Emma one day. He got very possessive of me and would not let Emma or Ramsey come close to me. He would come to me for scratches and then walk off in disgust at the first touch.

One afternoon, when I went out to move the fence for their daily bit of strictly rationed grass, I felt a nudge in my back and turned to find Ben giving ME the dragon eye and trying to get me to move faster. I flicked him on the nose and told him drugs or no drugs he better not think about chasing ME unless he really wanted to meet a dragon.

For about a week, my normally happy, harmonious herd was anything but. Emma and Ramsey watched Ben stomp around with wide-eyed disbelief. Emma was still not talking to me. Ramsey HATES the cold and gets very grumpy about it. He was not happy about the rudely abrupt start to winter and was very mad that I had tried to get away with using Emma's lightweight blanket on him since he outgrew his good Rhino Wug. That proved to be a bad idea since he was not warm enough. Ramsey is even more of a wimp about winter than I am and sweet, gentle Ben had turned into a very prickly, irritable, fire-breathing dragon.

I had been hoping to wait until the after Christmas sales to buy Ramsey a new blanket, but I finally broke down and paid full price for a new Rhino Wug, which made Ramsey much happier. Emma finally started talking to me again and we all stayed out of Ben's way until that dragon got used to his new drugs and crawled back into his cave. He will get a new blood test in January and we will go on from there.

Peace and harmony are coming back into my little herd. Between vet bills, Prascend, a new blanket and my new camera, my credit card is now the one crying for mercy and begging for St. George to ride to the rescue.

I mentioned yesterday that Ben is on some new medication. That is because I had that niggling little feeling in the back of my mind that something wasn't quite right. I knew what it was, but I didn't do anything about it for quite a while as I was clinging to denial. Unfortunately, I've never been very good at that. I often think that life would be a lot easier if I could embrace denial, but it remains elusive.

I saw the signs when I looked at pictures like this one taken in May...

Ben is just dozing and he looks rather scruffy because he was shedding. However, you can also clearly see the hollow along his spine that indicates a loss of muscle mass down his topline. That can be an indication of inadequate protein in the diet, especially in older horses, but I know that is not the case here, Ben gets plenty of protein.

There were a couple of times that I trimmed Ben's feet late this summer and he became sore afterward for no apparent reason. I am firm believer that a hoof trim should never make an animal sore and if it does there is either a problem with how the farrier did the job or a problem inside the animal and the feet are trying to tell you. The eyes may be the window to the soul, but the hooves are the window into the body.

That loss of muscle can also be an early sign of Cushing's Disease, as is a scruffy coat that sheds unevenly or slowly. Some other very subtle early symptoms of Cushing's are lethargy or variations in energy level, a swollen sheath/udder, chronic white line disease that does not respond to aggressive treatment, dullness or disinterest in the environment, increased likelihood and severity of infection....the symptoms are many and varied depending on the individual and you have to know your animal well to see them.

I knew in Ben's case that I had not done anything that should have made him feel sore. However, late summer is when a natural rise in the levels of a hormone called ACTH begins. In this area it peaks in the last two weeks of September and then begins to taper off.

The normal levels of ACTH are between 9 and 30. During this seasonal rise, it is common for the levels of healthy animals to be as much as 3 times the high end of this range. The ACTH levels in animals with Cushing's can rise as high as 1000. This huge upswing in ACTH can trigger a bout of severe laminitis and most horses first get diagnosed with Cushing's when they have a sudden case of acute, life-threatening laminitis in the Fall for no apparent reason.

Thankfully, this never happened to Ben, but the fact that he got ouchy on his feet after a routine trim tripped more alarm bells in my mind. The fact that I keep the donkeys on a diet of low sugar/starch hay with very limited access to grass is probably what kept Ben from having worse problems.

I might have been able to continue clinging to my denial for a while longer, but I had also been trying to convince Riding Buddy to get Hawkeye tested for Cushing's. I have been highly suspicious about him for several years now, mostly because he continues to have problems with his feet that should have responded to treatment, but never have.

We talked to the vet about it and found out that the manufacturer of the only drug used to treat Cushing's has a program every Fall where they will pay for ACTH testing. Given the opportunity to have the testing done at no cost, neither RB or I could find any excuse to put it off any more.

I was not surprised when Hawkeye's test came back unequivocally positive. His ACTH was around 300, which left absolutely no doubt. Ben's test came back at 95, just over the upper threshold of the high limit during the seasonal rise. Hawkeye was started on meds right away, but we decided to wait a month and retest Ben in November. His second test came back at 64 when it should have been well below 30 by then and the last shreds of my denial blew away.

Saturday, December 16, 2017

I went out this afternoon intending to finally play with my new camera. The past few days have been super cold and windy and I was afraid the camera might freeze to my hands so I have not done much with it. Today, the wind died down at least and the models were willing to leave the barn.

Emma wasn't interested in posing for me. She is finally starting to talk to me again after the terrible, awful procedure I foisted on her. She has just begun allowing me to give her some ear rubs and butt scratches, which is generous of her. She told me not to push my luck with that pesky camera though, so I kept my distance.

Ramsey was willing, but getting a quasi decent picture of a brown donkey in the snow on a grey day was more than we could manage.

Fortunately, I had one big, nosey volunteer who isn't yet sick of having his picture taken.

Ben is on some new medication (which I'll tell you about in my next post) and has been having a bit of a tough time adjusting to it. However, it's been about three weeks now and it is all smoothing out and he is feeling better.

I guess he decided it was time for an up close and personal exam to prove it.

Tuesday, December 12, 2017

Do you like reading this blog? Shopping online? Watching YouTube videos, NetFlix, cute cat videos? Even cuter donkey videos? Do you work from home? Do you rely on Internet sales to pay your bills? Do you like FaceBook? Twitter?

Do you use the Internet?

If the answer to any of the above is yes, then please call your Congressman right now and demand they uphold Net Neutrality.

Saturday, December 9, 2017

These don't think that the very little bit of grass they get each day is enough and let me know frequently that they are displeased. Can you feel the stare? They are making the paint peel off the front of my house.

This one thinks that anything less than 500 frisbee throws per day is insufficient. I'm sure you can feel this stare.

There should even be frisbees in the woods to hunt, but squirrels will do.

And this one thinks the chef should be serving 6 meals per day.

***
I hope that all of my California friends and readers are OK in these awful fires. It seems like this year has been one long disaster and I wish there was more that I could do.